Loss Is Their Gain

Controversial Pills Still Popular With Local Dieters

September 10, 1997|By NANCY FEIGENBAUM Daily Press

Controversy hasn't discouraged Jim T. Smith.

For almost a year he has been using a prescription diet pill to bring his weight down, despite escalating warnings about the pills' side effects. And the pills have worked. Between November and today, the 50-year-old from Williamsburg has dropped from 272 pounds to 190.

What's more, his cholesterol and blood pressure have fallen from dangerous to normal levels. Smith has stopped taking blood-pressure medicine, and symptoms that suggested he was developing kidney problems have disappeared.

``I have way, way more energy than I used to have. I used to go home and eat and go to the recliner,'' he said. ``The benefits that I have received out of this are far outweighing the concerns I initially had. I'm kind of back to being a human being again, where I can do things. It's unbelievable, when you take 80 pounds off, the things you can do differently.''

Smith has plenty of company in trusting diet pills.

Dieters continue taking prescriptions for Redux and fen-phen (a combination of medications), even as publicity grows about possible health hazards of prescription appetite suppressants. Doctors at two medical clinics announced this summer that they had noticed a rare heart valve problem in some patients taking fen-phen. The FDA also has reported four cases of heart valve damage in users of a similar diet pill, known as Redux.

Though no medical study has been conducted to test that link, the Food and Drug Administration decided last month to require new labels on the pills warning of the potential danger.

Diet drugs are also thought to pose a risk of pulmonary hypertension, which can fatally damage the lungs and heart muscle. A new study suggests an additional hazard: that high levels of the drugs can interfere with serotonin, a critical brain chemical that acts as a neurotransmitter.

But on the Peninsula, it is not hard to find people who use the medicines and are ecstatic about the results.

``I didn't want to overeat. And I definitely didn't want sweets, which is really my downfall,'' said Freddie Cottrill, 45, of Yorktown. ``I could take a bite out of a little peace of candy, and that would be it.''

Cottrill, who is 5 feet 5 inches tall, lost 40 of her 162 pounds using fen-phen last year. She recently regained eight pounds after splurging during a vacation, she said, and has come to realize she has to keep a close eye on her weight to keep it off.

Local patients who take Redux and fen-phen are supported by doctors who say the pills are no more dangerous than many other prescription medications, and that obesity should be treated as a serious medical condition.

``You can treat a person's high blood pressure, their diabetes,'' said Dr. David Belvin, a family doctor in Norge. ``Or a doctor can try treating the obesity first to see if they can try to improve all those other medical problems.''

Medications for high blood pressure and diabetes can have side effects too, said Belvin, who works for the Williamsburg Medical Arts division of Riverside Physician Associates. If weight loss allows someone to drop those medications, why not consider an effective treatment?

Belvin is giving a public speech Thursday in Norge about appetite suppressants, trying to answer questions about their safety and usefulness.

He will say that diet pills may be useful to people who are seriously overweight but must be prescribed carefully, like all medication. They are not for people with mild weight problems, who simply want to look better, he said, and they work only in combination with other weight-loss measures, such as a balanced diet and regular exercise.

In that sense, the publicity over the pills may serve as a warning for doctors who were prescribing them thoughtlessly, he said.

Diet pills have seesawed in popularity since the 1950s and 1960s, when doctors prescribed amphetamines later found to be harmful and addictive. There was a backlash, then came the new generation of medications that are not addictive.

``They're not as innocuous as they once thought,'' Belvin said. ``It's like, for example, when Redux first came out. Man, the sales just went sky high. That tells you, doesn't it, that the prescriptions are a little indiscriminate.''

Belvin's advice conforms with that of Smith's doctor, William Massey III, a Williamsburg internist whose clinic treats many people trying to lose weight. Massey said weight-loss pills often are part of a careful regimen in his clinic, where patients come back every three weeks to have their health and progress monitored.

``There's more to losing weight than just taking a pill,'' he said.

He still believes in the pills, despite the recent questions about heart-valve problems. Massey said he prescribes the appetite suppressants in much smaller doses than recommended and only after a thorough physical.